Figures & Tables
Figures
- FIGURE 1
Systematic Process Framework for Conducting Implementation Science Research in Food Fortification Programs
- FIGURE 2
Example of a Theory of Change Model for Food Fortificationa
a Created by members of the Global Fortification Technical Advisory Group.
- FIGURE 3
Example of Phase I, Step 2 of Food Fortification Implementation Framework
- FIGURE 4
Possible Next Steps After the Conclusion of an Implementation Research Study
Tables
Implementation Outcome Variable Working Definition in the Context of Food Fortification Related Terms in Food Fortification (Non-exhaustive) Examples of Interpretations for Food Fortification Programs (Non-exhaustive) Acceptability The degree to which food fortification (or an innovation that addresses a precondition to the increased consumption of adequately fortified foods) is agreeable to stakeholders Perceived operability; myths, taboos, and beliefs; perceived cost- benefit; perceived affordability; perceived business advantage or disadvantage; organoleptic/sensory properties Acceptability of food fortification technology by industry; acceptability of the intervention by policy makers; acceptability of the addition of micronutrients to food by consumers; acceptability of a price increase by consumers Adoption The uptake, utilization, intention to try or intention to consume any product, activity, or innovation related to food fortification Uptake; penetration; utilization; intention to try or intention to buy/consume Adoption of food fortification by producers; adoption of a fortification logo; use or intended use of fortified products by consumers Appropriateness/ Feasibility The perceived (or actual) fit, relevance, or compatibility of food fortification for a particular context; the ability of food fortification to reach a particular target group (e.g., women of reproductive age who are below the poverty line) Practicality; perceived fit; relevance; suitability; operability Appropriateness of the food selected to fortify; appropriateness of the micronutrient compound being used by food processors; feasibility of fortification in the context of the state of the production industry (e.g., centralized vs decentralized processing); appropriateness of the technology being used by producers; appropriateness of the intervention to address a particular micronutrient deficiency; feasibility to enforce legislation Coverage The degree to which the targeted population is consuming fortified products regularly or able to access fortified products Reach; access; penetration; consumption amongst the population; coverage of the target population Penetration of fortified products in the market; percentage of the population that can access fortified products Fidelity The degree to which activities related to food fortification are occurring according to original program plan, policy, or protocols Compliance; adherence; quality; delivery as intended Compliance of the micronutrient compound with national standards; compliance of micronutrient levels found in foods with allowable ranges that are specified by national standards Implementation Cost The total cost of implementing all activities related to achieving increased consumption of adequately fortified foods Program cost Total cost per beneficiary of reaching 80% coverage of fortified foods Sustainability The extent to which fortification is institutionalized within the government and industry and not reliant on continuous external inputs and support Institutionalization; integration; non-reliance on external inputs; ownership by the government, industry, and society Degree to which the government can monitor and enforce food fortification; degree to which complying with fortification requirements is a viable business model for producers Example Program outcome and underlying assumption/determinant Increased access to fortified products. Fortified products are affordable and available for urban populations Research question(s) What is the national coverage of fortified products amongst the urban poor? How will the success of the intervention be affected by the information provided? The urban poor are a large proportion of our target population. If we are not currently reaching them, we will need to adjust our program with new targeting strategies. Possible research methods Secondary analysis of existing data set Organization/persons responsible for conducting the research The National Micronutrient Committee Resources, support, or training required by the organization/persons Human resources to analyze data and write report Estimated cost No additional cost to program Estimated time to prepare for and conduct the research 6–8 weeks - TABLE 3.
Implementation Research Objectives With Examples for Food Fortification Programsa
Research Objective Description Examples To describe Describes the context in which food fortification is occurring and the main components that may affect the success of food fortification What proportion of the population consumes wheat flour that is produced in industrial mills? To explore Explores the possible barriers and facilitators to the implementation of food fortification What are the barriers and facilitators for implementing adequate external quality assurance/quality control? To explain Explains how and why certain aspects of the intervention or the context may influence implementation outcomes How do market prices affect revenue margins for wheat flour millers? To influence Tests desired effects of an implementation improvement strategy Does additional training and fortification sensitization of millers lead to better fortification of a product? To predict Predicts whether the same (or modified version of) aspects of a food fortification program will work under various conditions (useful for scale-up) Will the radio advocacy materials that increased fortification logo awareness in the southern parts of the country also produce similar results in the northern parts of the country? ↵a Adapted from Peters DH, Tran NT, Taghreed A. Implementation Research in Health: A Practical Guide. World Health Organization; 2013.
In this issue
Statistics from Altmetric.com
Jump to section
Related Articles
Cited By...
- No citing articles found.